Disaster planning is imperative in any institution. Due to the unplanned nature of accidents and emergencies, it is only wise if workers of any organization are prepared to deal with the same. Research conducted in the hospital setting confirmed that nurses who were well versed in disaster planning were more confident and exhibited excellent management skills. They also stressed the importance of emergency preparedness in the hospital.
Similar research was conducted by Chapman and Arbon in 2008 asserted that approximately 96% of all the nurses working in the emergency department had an effective disaster plan. The majority of the hospitals value emergency plan and encourage its practice. A parallel study by Al Khalaileh in 2011 conducted using a different group of nurses seconded the claim. Failing to plan is planning to fail, and when it comes to disaster management, one can never be too prepared. The significant shortcoming in both types of research is that they were no allowance for further opportunities to enhance the implementation of the disaster plans.
In 2010, Al Khalaileh had previously conducted another survey that was descriptive and cross-sectional in nature. The aim of the study was to assess the perceptions of nurses concerning their disaster management skills. Despite the fact that the participants of the research were general nurses, the results still apply as the events were similar to the emergency nurses.
The method that was used in data collection was questionnaires that attracted a very encouraging response rate of 85.3%. The total number of distributed questionnaires was 600, and they were mainly administered to emergency nurses for best results.
After having eliminated the invalid questionnaires that were either partially filled or entirely blank, the research team secured a total of 474 that qualified for analysis. The reason behind using questionnaires as a data collection tool was because they could be distributed to a large number of participants and were very cost effective. In the meantime, the research team ensured that they used the appropriate techniques to select the required sample population.
Unfortunately, the results proved that nurses were moderate to poorly prepared for disaster management and this was a major concern. The nurses still had a long way to go as far as being prepared for disasters is concerned. The results were backed by Rassin (2007) and Baldwin (2005); both sources indicated inadequate preparation for emergency management. OSullivan (2008) conducted a similar research using a web-based survey and targeted the Canadian nurses to assess their preparedness level. He is especially interested in the nurses who worked in the critical care units and accidents and emergencies.
The scope of the research was substantial since a total of 1,543 nurses were assessed. However, it is important to note that a broad cross-section is not usually a guarantee of representativeness. The best thing about a large sample is that it enhances the validity of the study. (Polit & Beck, 2010). The sampling strategies were indicated to avoid selection bias as a measure of getting the accurate and fair picture of the results. It is through these strategies that the research team could be able to generalize their findings without compromising on the truth. Therefore, if more than 90% of the total nurses assessed were working in the emergency department, it would be safe to assume that the research findings were reflective of the status of the emergency nurses.
According to the results, the preparedness levels of nurses depended on the nature of the disaster. The disasters that nurses were well prepared for include: infectious diseases outbreaks, natural disasters, and nuclear disasters. The above can allude to the fact that infectious disease outbreaks have been on the rise in the recent past. An example of such an outbreak is the acute respiratory syndrome. The more the nurses dealt with these cases, the better prepared they become.
Experience also came in handy. Nurses who had many years of experience in disaster management perfected their skill and could not be compared with newbies. The level of experience determined the preparedness and this finding was supported by Hammad (2012). Experience improved the confidence of nurses making them calm and composed while managing disasters. There was a class of nurses who were clueless about an emergency plan and whether their hospital had such provisions. They proved to be of little supportive measures and required education and training programs to be brought up to speed. Such nurses who were under-prepared for disaster management were more of liabilities than assets to the hospital. There is no definitive local research to assess emergency nurses; the findings could apply to them too (Polit and Beck, 2010).
Nevertheless, the fact that the study population was Canadians, their preparedness levels were dependent on several factors such as local hospitals plans, the policies that they were subjected to, and the resources available for disaster management. Consequentially, these factors had a significant impact on the perceptions of nurses working in different hospitals and ought to be taken into consideration. In general, the conclusive findings were that emergency nurses could improve their attitudes, training, and level of preparedness in managing disasters.
Preparedness of Nurses for Emergency Response in ED
A couple of factors can affect the level of preparation of emergency nurses for disaster. Some of the methods have been highlighted in the above literature such as experience, training, exposure to disaster, and the nature of the disaster. All factors constant, these factors could significantly improve or deteriorate the level of preparedness of emergency nurses.
Hammad (2012) undertook a study to investigate the current stand of nurses working in emergency departments and how prepared they were for a disaster. The inclusion and exclusion criteria were indicated in the reviews and the sources used were published between the years of 2000 and 2011. The sources had to be relevant to the topic and from trusted authors. All factors were taken into consideration such as medical perspectives and arising concerns.
The findings indicated that disaster education and training, previous disaster experience and emergency plans have an impact on staff preparedness levels.
The findings were that education and training were not enough a factor as it varied from one source to another. The level and amount of training offered at one hospital were not the same as the next hospital. The means of administration also varied. For instance, some hospitals went for live interactive seminars; others opted for disaster drill, classes, and others hands-on experience. Needless to say, these methods are not equally effective. Although Chapman and Arbon (2008) emphasized that senior nurses' knowledge for disaster response improved with pre- and post- education interventions; the reviewers in this study stressed that there were discrepancies. These results are consistent with the results of Rassin et al. (2007), who found there was a lack of educational programs for healthcare providers in general.
Regarding nurses experiences, it is quite obvious and expected that senior nurses had the upper hand. Such nurses have handled many emergency cases and have seen what it is like to work under pressure. In contrast, less experienced nurses are likely to be tense and confused in the event of a disaster. They may not have the necessary skills, speed, and quick decision-making skills required for handling a failure. The results were in line with the findings of Chapman and Arbon (2008). It takes the time to build self-confidence and the ability to stay calm in a disaster.
Although a department's emergency plans could increase staff preparedness levels, the reviewers highlighted that these schemes were not known by most nurses and did not address their needs and concerns in disaster situations. As a consequence, this could reflect negatively on the success level of emergency management. This finding is supported by Duong (2009), who found that although 87% of respondents stated that they knew the location of their department's disaster plan, 42% admitted that they had not read it.
Hammad (2012) insisted that a pre-preparation phase was necessary for the process of preparing emergency nurses for disasters. This step is important as it gets the nurse in the mood of learning which is different from the standard working environment. Doung (2009), upon investigating emergency nurses in South Australia confirmed the same through a descriptive and exploratory research. When it comes to research pertaining medicine, a couple of methods can be employed depending on the research conducted. Research designs vary based on the nature of information, sources of data, target population, data collection methods, data analysis techniques and instruments used in data presentation. Another important factor considered in the selection of research design for a project is the shape that the collected data takes. There are two primary categories of research based on data namely, qualitative and quantitative. Qualitative research focuses more on the why and how a decision was arrived at. It cannot be measured, and its primary concern is to understand in-depth the human behavior and the reason behind it. On the contrary, quantitative research focuses on measurable facts and is usually represented statistically.
A descriptive research design will provide insight to the study population. Its primary focus is answering the what question. It may not necessarily explain or expound on why, how or when people become self-actualized, and that is okay because the research is focused on the process of being an idealized self and what needs to be done. Descriptive research designs incorporate case study aspect in that a selected population is interviewed, observed and studied to understand behavior and come up with a pattern or trend. A descriptive research design is explanatory in nature, and a lot can be gained from the study population. The quantitative aspect is minimal and majors on qualitative results which makes it the best design to employ in such a case (Polit & Beck, 2010).
Some guidelines were necessary for the selection of the participants to ensure the validity and reliability of the results. According to Bums and Grove (2011), the literacy of the participants tops the list. Literate members are in a capacity to read and understand the questions and give their answer accordingly. A lot of researches have questionnaires as the primary data collection technique and this calls for literate participants. The response rate in this study was 60% which was impressive. (Boswell & Cannon, 2011)
While using a Likert scale to determine the confidence level of nurses in disaster management, the findings were that 45% of the emergency nurses were less confident, 36% were confident, and 19% were overconfident. The Likert scale involves asking the nurses a series of questions to which they respond to in the assertive or negative. Each answer carries a mark, and the total marks are summed up at the end of the exercise to come up with the final score (Polit & Beck, 2011).
Chapman and Arbon (2008) came up with a different result. They suggested that previous exposure may or may not impact the nurse's confidence levels. In their findings, 55% of the participants were confident although only 37% of them had been involved in disaster events in the past. Even though the study indicated the different roles that nurses occupy, it did not mention the years of the emergency nurses' experience. The level of experience...
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